Introduction
The development of capsule endoscopy (CE) and balloon-assisted
enteroscopy (BAE) has enabled endoscopists to better manage obscure
gastrointestinal bleeding (OGIB) [1-3]. Among patients who have
OGIB, Meckel’s diverticulum (MD) can be an important differential
diagnosis for OGIB patients. Although MD is usually asymptomatic, it can
be a cause of various clinical symptoms such as gastrointestinal (GI)
bleeding, intestinal obstruction, and acute abdominal pain. While there
are several specific examinations used to diagnose MD, including CE
[4], BAE using a single or double balloon [5], technetium 99m
pertechnetate scan [6], and arteriography [7], it is sometimes
difficult to obtain a definite diagnosis of MD. The resection of MD is
necessary when judged as a source of clinical manifestations.
CE is less invasive than BAE, and the diagnostic ability of CE has been
reported as superior to BAE for OGIB patients [2, 8]. Therefore, CE
is usually the first method used to identify OGIB. Although CE is
considered as a safe procedure, the risk of capsule retention exists.
Capsule retention is defined as the capsule remaining in the GI tract
for more than 2 weeks [2]. The main cause of capsule retention is
small intestinal stricture. The reported etiology of small intestinal
stricture includes drug-induced small intestinal stricture due to
nonsteroidal anti-inflammatory drugs, tumors, inflammatory bowel
disease, postoperative stricture, and stricture induced by radiation
[9]. Here, we report a case of simultaneous small intestinal
bleeding and stricture due to MD.